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WASHINGTON, DCWhile reporting programs have raised
the profile of hospital quality measurement and improvement in 12 communities
across the country, lack of coordination among reporting programs and inadequate
resources hinder efforts to improve patient care, according to a study by Center
for Studying Health System Change (HSC) researchers in the September/October
edition of Health Affairs.

"Despite the dizzying array of hospital quality-reporting programs, theres
still a key unanswered question: Does quality reporting affect patient outcomes
enough to justify the enormous resources hospitals are investing in it?"
said Hoangmai H. Pham, M.D., M.P.H., lead author of the study and a senior researcher
at HSC, a nonpartisan policy research organization funded principally by The
Robert Wood Johnson Foundation.

The Health Affairs article, titled "The Impact of Quality Reporting
Programs on Hospital Operations," is based on HSCs 2005 site visits to
12 nationally representative communitiesBoston; Cleveland; Greenville, S.C.;
Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey;
Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking
change in these markets for the past 10 years.

Researchers interviewed 111 health care leaders about hospital quality-reporting
programs, including executives at 36 of the largest hospitals in the 12 communities,
officials at the Centers for Medicare and Medicaid Services (CMS), the Joint
Commission on the Accreditation of Healthcare Organizations (JCAHO), state hospital
associations and state reporting programs.

All 36 hospitals participated in quality-reporting programs sponsored by CMS
and JCAHO, which tie increased payment rates and accreditation, respectively,
to participation.

But all 36 hospitals reported participating in additional quality-reporting
programs (range 1 to 7), despite little evidence that individual reporting programs
help improve care quality, and when there is no evidence on how multiple programs
interact. In total, respondents identified 38 unique reporting programs.

The 38 programs varied not only in clinical focus and reporting requirements
but also in sponsorship, incentives, mandatory versus voluntary nature, inclusion
of outcome measures, and provision of concrete quality improvement support,
according to the study.

Hospitals have devoted additional resources and staff to quality measurement
and improvement, but inadequate information technology (IT) systems have added
to the staffing burden of reporting, the study found.

"All reporting programs could benefit from more deliberate coordination
to decrease reporting burden. Coordination could foster more consistent or complementary
sets of target conditions across programs and standardized technical reporting
formats. Although JCAHO and CMS initiatives were tightly coordinated in design,
this cooperation has not extended to most other programs, particularly private
programs," the article states.

### ###

The Center for Studying Health System Change is a nonpartisan policy research
organization committed to providing objective and timely research on the nations
changing health system to help inform policy makers and contribute to better
health care policy. HSC, based in Washington, D.C., is funded principally by
The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy
Research, Inc.